PH and Zebras Have a Lot More in Common Than Their Rarity

They're deceptive, aggressive — and patients, like the animals, protect their own

Colleen Steele avatar

by Colleen Steele |

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Imagine you’re walking through an open field. It’s quiet except for the faint trickle of a nearby stream and a rumble that sounds like thunder in the distance. The thunder seems to get closer, and soon you realize it’s the sound of galloping hooves.

Expecting to see wild horses run past, you’re surprised when loud braying replaces the clop of hoofbeats down by the stream. As you begin to walk in their direction, you stop short. Is that barking among the braying? Are they accompanied by dogs?

Those aren’t horses. They’re zebras, and they’re often described as making four distinct sounds: a bray, a snort, a nicker, and yes – a bark! Get out of here!

And what’s more, zebras can be much more dangerous than wild horses.

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How Will You Answer the PH Community’s Call to Action?

Assuming you’re hearing the common hoofbeats of a horse and not those of a zebra could prove deadly, yet this, in a sense, is how doctors are trained to think. Diagnosis begins with the simplest, most likely answer, and only after eliminating the obvious are doctors advised to probe for something rare or unlikely.

This systematic process is time-consuming when time could be of the essence. Rare diseases aren’t just uncommon; they’re often incurable and life-threatening, and can advance at unpredictable paces.

The National Organization for Rare Disorders (NORD) has chosen the zebra as the official symbol of rare diseases in the United States. NORD reminds patients, “Everyone has his/her own stripes, those characteristics that make each individual distinct.”

Pulmonary hypertension (PH) is one of many rare diseases that use the zebra as a mascot to raise awareness. In the 2020 “30 Days of PH” campaign for BioNews, the parent company of this website, PH patient Barbara Thompson (aka the Zebra Lady) shared how wearing a zebra print every day of the year has helped her educate others about her rare disease.

“I developed a business card that I give out regularly that explains the zebra analogy and briefly describes PH. Included are graphics of my zebra named PHyllis,” Barbara wrote.

In a previous column, I explained why periwinkle is the perfect color choice for the PH ribbon. Now I’m supporting the zebra as the perfect rare disease mascot. Its appearance and temperament make it the ideal choice.

Looks can be deceiving

PH patients often hear inconsiderate comments such as, “You don’t look sick.” PH treatments like vasodilators can cause a deceiving flush to one’s complexion and mimic healthy skin color.

Zebras look like horses with stripes, but they’re more closely related to wild donkeys. Although they don’t look intimidating, just like PH, they can be aggressive and unpredictable.

I’ve done some light online research about these seemingly harmless creatures, and I’ve learned they have a dark side. Zebras are more stubborn than their donkey relatives and have a shocking disposition for violence. According to Discover Wildlife, “Zebras have been known to kick each other to death, they will viciously bite any human that comes too close, and there are even many accounts of zebras killing lions.”

PH and zebras have this chilling thing in common: They can both be unassuming killers, and even babies or foals aren’t protected from their attack.

Got to be faster than that

I learned from Science Alert that not only can zebras break a lion’s jaw with one kick, but they also possess a ducking reflex to help them avoid being caught by lasso.

It makes me think of how PH can avoid being caught by doctors because its symptoms imitate those of more common diseases.

All bets are off

That same Science Alert article offers a brief history lesson on how people have tried to control zebras. “Although it appears possible to tame individual zebra,” it says, “this species was not a good candidate for domestication.”

Sound familiar? Treatments can stabilize PH, but the sad and disappointing reality is that there is no cure, and so far there doesn’t appears to be a suitable candidate.

More than meets the eye

PH patients commonly struggle with other diseases or health conditions, as well as their PH. Dealing with comorbidities makes treating and living with PH that much more complicated.

Speaking of complicated, zebras aren’t horses or donkeys, but the Helpful Horse Hints website claims they can breed with either and create a hybrid. It must take a specially trained veterinarian to differentiate between these mixed species, known as zorses, zonies, and zonkeys.

When dealing with PH and comorbidities, it’s best to see a PH specialist who can differentiate between them and safely treat them all.

All for one and one for all

If a zebra in a group is wounded or injured, the others will circle and protect it from hungry attackers. It reminds me of how fiercely the PH community supports one another.

Lastly, a group of zebras is often called a dazzle. I think that’d make a great name for the PH community, as we continue to display our stripes and dazzle the world into PH awareness.

Note: Pulmonary Hypertension News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Hypertension News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to pulmonary hypertension.


mamabear007 avatar


I like your take on the different ways PH can be similar to zebras. You broought up points that I hadn't considered, mostly because I didn't realize how violent and dangerous zebras can be.

Barbara Thompson avatar

Barbara Thompson

What a great article, Colleen, I've never thought of this comparison but you are right on the money. Thank you for all you do for the PH community.


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A Conversation With Rare Disease Advocates